Charity care and bad debt at the state’s 13 hospitals rose for yet another
year, according to a report released last week by the state Department of Health.
The dollar figure for charity care rose to $15.7 million (0.8 percent of patient revenue) and $45 million for bad debt (2.3 percent of patient revenue). The local hospitals have delivered more than $14 million in charity care every year, except for 2001, when the total accounted for just $11 million.
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Last year, bad debt totaled about $42 million. Bruce Cryan, the Department of Health analyst who wrote 2003’s “Hospital Community Benefits Report,” said the uncompensated care totals have risen fairly flatly since the state began issuing the report annually. The dollars have annually risen at about $1.3 million over the past nine years.
“This is done in an effort to monitor the quality and access these hospitals are providing to the community,” Cryan said. “As far as a health care safety net goes, the state really relies on the hospitals.”
Except for rehabilitation facilities, Cryan said all of the hospitals in the state operate as non-profit organizations, relying on subsidies, tax exemptions and charitable contributions to operate.
Breaks on property taxes or reduced borrowing rates are typically provided by a community which anticipates getting something back in turn. Cryan notes in the report that charity care and bad debt are the most accurate measures of a hospital’s community benefits.
Charity care includes charges for services delivered, but not billed, because the hospital determines a patient is incapable of payment. Bad debt is the bill charges for services delivered, but never collected, and which are then written off. Because each hospital’s charges are unique, all of the audited numbers were cost-adjusted.
Taken as a percentage of their total net patient revenue, Butler Hospital (4.6 percent), Newport Hospital (4.5 percent), Roger Williams Medical Center (4.3 percent) and Rhode Island Hospital (4.2 percent) delivered the largest percentages of uncompensated care. Rehabilitation Hospital (0.8 percent) and Women & Infants Hospital (1.7 percent) were the only institutions below 2 percent.
“There’s no reason to think this level can’t continue,” said Cryan, who added that there are no available benchmarks to compare what a high amount or a low amount would be. As an example, in the report he noted that comparing dollar figures are meaningless, pointing to Kent County Hospital’s $16.5 million and Westerly Hospital’s $5.7 million in uncompensated costs, amounts which both worked out to 2.5 percent of their patient revenues.
The report is available at the Department of Health’s Web site at www.health.ri.gov.
The report also documents the level of diversity in hospital governance, compliance
with uncompensated care licensing standards and individual community benefits
activities ranging from workshops and hotlines to family vans and immunization
clinics.
